Maximizing Insurance
When it comes to leveraging your healthcare coverage for Sjögren’s Syndrome it might feel like a daunting task, however, with our help and knowledge we can assist you in obtaining that approval. We fully believe leveraging your medical insurance and minimizing your financial burden is how insurance should function, and we’ll detail the typical steps it takes to ensure this happens throughout this post.
Understanding Your Insurance Policy
Once you receive your Sjögren’s diagnosis we will ask to review your plan policy. This document will detail what and where coverage can be granted. Not all policies allow for treatment necessitated by Sjögren’s Syndrome, but as research continues in that realm the coverage options are expanding as well. Once we understand how your insurance could help cover your treatment, we will give you a brief rundown of what could be expected out of your pocket – deductible, out of pocket maximums, co pays, ect.
Network Providers and In-network Benefits
When it comes to insurance there are several options on who you can choose to provide your care. Some plans offer in-network only benefits, where others allow members to leverage out of network benefits. While we recommend seeing in network providers, sometimes that isn’t aways an option! At Ozark Prosthodontics we will try our hardest to leverage your in-network benefits and further minimize your out-of-pocket expenses, even if we are out of network with your health insurance.
Preauthorization
After your new patient evaluation, we will go through additional steps including prior authorizations, voluntary benefit inquiries, and pre determinations so we have confirmation your plan will work. We understand the stress that comes with finding providers who will leverage your medical insurance and seek out the peace of mind that this will be covered for our patients.
Utilize Preventative Care Services
As research into Sjögren’s Syndrome continues there are additional coverage options specifically in the world of preventative medicine. For example, with some dental insurance plans offered in Arkansas there are additional dental cleanings allowed to help protect and preserve your teeth. In some health plans offered in Arkansas including those of school and state employees there are coverage subsections dedicated to prevention and reconstruction!
Appeal Denied Claims
Occasionally, there are some claims that still get denied even after we get prior authorizations, but that is no worries here! We have extensive history with appeals and will exhaust every option available until your claims are paid for. We believe that medical insurance should cover medically necessary treatment and will go up to bat daily to ensure that for our patients.
If you are curious about your medical insurance plan and coverage for Sjögren’s Syndrome we’re here to help! Reach out to us and we’ll be able to guide you on next steps to getting covered. As always, Our Patients, Our Priority!
